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NPI Code Detail

MEDICARE: CHASE HEALTH PHARMACY PC

MEDICARE: CHASE HEALTH PHARMACY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy5301010232MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12139654OTHERPK

General Provider Information

NPI Number : 1568891703
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHASE HEALTH PHARMACY PC
Provider Business Mailing Address
First Line : 6200 CHASE RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2108
Country : US
Telephone Number : 313-769-6817
Fax Number : 313-769-6814
Provider Business Practice Location Address
First Line : 6200 CHASE RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2108
Country : US
Telephone Number : 313-769-6817
Fax Number : 313-769-6814
Authorized Official
Title or Position : PHARMACIST IN CHARGE
Name : ABIR SHUKR
Credential :
Telephone Number : 313-673-6565
Provider Enumeration Date : 11/08/2013
Last Update Date : 01/29/2014

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Directions to “CHASE HEALTH PHARMACY PC ” Practice Location

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